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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 31, No 5, September/October 2020
244
AFRICA
Simple cardiac blood test before surgery can predict adverse outcomes
A common cardiac blood test done before surgery can
predict who will experience adverse outcomes after most
types of surgery, says an international study led by Canadian
researchers.
Globally, of the 200 million adults who undergo major
surgery, 18% will experience serious cardiac and vascular
complications including death within 30 days following
their intervention, such as hip and knee replacements, bowel
resections and abdominal aortic aneurysm repair.
‘Any type of surgery has the potential to cause damage to
heart tissue, through blood clot formation, long periods of
inflammation, or bleeding,’ said study lead, Dr PJ Deveraux,
professor of medicine, cardiologist at Hamilton Health
Sciences (HHS) and scientific lead for peri-operative research
at McMaster University and HHS’ Population Health
Research Institute (PHRI).
The VISION study looked at whether levels of a cardiac
blood test, NT-proBNP, measured before surgery can
predict cardiac and vascular complications. Higher levels
of NT-proBNP, which can be caused by various anomalies
in the cardiac muscle, such as stress, inflammation or
overstretch, can help identify which patients are at greatest
risk of cardiac complications after surgery.
The study included 10 402 patients aged 45 years or
older having non-cardiac surgery with overnight stay from
16 hospitals in nine countries. ‘As a result of these findings,
doctors can predict who is at greater risk of heart attacks and
other negative vascular events after surgery,’ said Devereaux.
This phase of the VISION study builds upon six years of
research studies to understand pre- and post-operative factors
that lead to cardiac complications. ‘This simple blood test can
be done quickly and easily as part of a patient’s pre-operative
evaluation, can help patients better understand their risk of
post-operative complications and make informed decisions
about their surgery,’ said first author of the publication, Dr
Emmanuelle Duceppe, internist and researcher at the Centre
Hospitalier de l’Universite de Montreal (CHUM), PhD
candidate in clinical epidemiology at McMaster University,
and associate researcher at PHRI. ‘This blood test is 20 times
cheaper than more time-consuming tests such as cardiac
stress tests and diagnostic imaging.’
Results of this simple blood test may inform the type of
surgery the patient will undergo, such as laparoscopic or open
surgery, the type of anaesthesia used during surgery and who
will require more intense monitoring post-operatively. Blood
test results can also reduce the need for pre-surgical medical
consultations for patients who show no risk for cardiac
complications.
‘Heart injury after non-cardiac surgery is emerging as
an important health issue requiring attention. Using CIHR
funding, the research group led by PHRI and Devereaux has
clarified the association between an elevation of a common
biomarker and the risk of per-operative morbidity and
mortality,’ said Dr Brian H Rowe, scientific director, Institute
of Circulatory and Respiratory Health, Canadian Institutes
for Health Research.
Source:
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